NPIMap

Organization Active NPI

Tioga County Dept. of Human Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mansfield, PA
National Provider Identifier
1396752309
Registry record updated Mar 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
228510 Issued in PA
Legal business name
TIOGA COUNTY DEPT. OF HUMAN SERVICES
Practice address
63 Third Street
Suite 103
Mansfield, PA 16933
Phone
(570) 662-7600
Fax
(570) 662-7726
NPI assigned
Aug 2, 2006
Last updated
Mar 25, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Max Harrison
Title
Administrator
Phone
(570) 724-5766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 228510 PA Primary

Addresses

Primary practice location

63 Third Street
Suite 103
Mansfield, PA 16933

Mailing address

1873 Shumway Hill Road
Wellsboro, PA 16901
Phone (570) 724-5766

Other identifiers 1

IdentifierTypeStateIssuer
1000000400025MedicaidPA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301011200000",
    "number": "1396752309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1873 SHUMWAY HILL ROAD",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "16901",
            "telephone_number": "570-724-5766",
            "fax_number": "570-724-6757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 THIRD STREET",
            "address_2": "SUITE 103",
            "city": "MANSFIELD",
            "state": "PA",
            "postal_code": "16933",
            "telephone_number": "570-662-7600",
            "fax_number": "570-662-7726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIOGA COUNTY DEPT. OF HUMAN SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-02",
        "last_updated": "2011-03-25",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "MAX",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "570-724-5766",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "PA",
            "license": "228510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000000400025",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.